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Predictors of Renal Complications in Children With Hematotoxic Snakebite
Kamirul Islam1, Soutrik Seth2, Atanu Roy2
1Department of Pediatrics, Burdwan Medical College, Burdwan, India. Correspondence to: Dr Kamirul Islam, Behind Rudra Automobiles, Khagragore, Burdwan 713 104, West Bengal, India. kamirul.islam7@gmail.com.
Objective:
To study the predictors of renal complications following hematotoxic snakebite in children.
Methods:
This comparative study was conducted in the pediatric ward of a tertiary-care centre among 364 consecutively children admitted with hematotoxic snakebite between January 2016 and December 2017. Clinical and laboratory indicators were compared between children who developed acute kidney injury and those who did not.
Results:
Acute kidney injury was seen in 139 children (38.2%), majority being stage 2 (55, 39.5%). 59 children (16.2%) developed permanent renal damage and 16 (4.4%) died due to envenomation. Acute tubular necrosis was the most common (25, 39.1%) histopathological change.
Conclusions:
Receiving anti-snake venom more than one hour after bite was the most significant adverse prognostic indicator, both for renal complications and mortality.
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Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

